Workday gave analysts a peek at another trio of companies from its venture investment portfolio earlier this month, following on from a similar event three months ago. All three ventures had interesting stories to tell — one of them, Zimit, we've previously written about; the other, Flatfile, announced a $35 million funding round this week and also deserves a write-up. But the standout for me was Vida, a virtual healthcare platform that sits at the center of a fast-brewing revolution in how we care for our health, enabled by digital connectivity. As its CEO Stephanie Tilenius told me:
If you fast forward the next decade, I think that healthcare is going to be transformed the same way that IoT or commerce was [by digital]. You're going to have this continuous care model where people are getting data on themselves every day.
Her presentation reminded me of an interview I had more than five years ago with Jeroen Tas of Philips about the potential for connected data to change people's healthcare journeys. The goal was to reorient healthcare away from giving acute care when things go wrong, to instead focus on monitoring and ameliorating the long-term chronic conditions that already account for more than 70% of health costs. Five years on, Vida is making solid progress in addressing that same goal. Tilenius explains:
One of the challenges in our healthcare system is that we always have a reactive view of healthcare. So it's usually late. And it's very physician-centric — but we have a shortage of physicians across the globe.
So we tend to historically treat chronic disease after you've had it for a long time. You go to the ER, you go to the doctor, we give you prescription medication. And by then it's often too late ...
If you're living with diabetes, or depression, those are chronic diseases. They don't just evaporate. You don't just go to the doctor, have a seven-minute conversation and take a drug, and then you're done. It's not that simple.
Making an impact on diabetes and depression
Vida has been successful by focusing on a specific set of diseases — primarily diabetes, high blood pressure, anxiety and depression — and using a combination of monitoring, mentoring and therapy to help people change their behaviors and thereby improve their condition. All of this happens via a mobile app which connects users to live therapists and coaches, digital content, and monitoring devices. This produces measurable outcomes, as Tilenius explains:
What we will typically see over a period of 3-6 months, is someone who comes in with diabetes will lower their A1c over a point, which is very material. That may in fact enable them to go off their diabetes medication. And at the same time, they're lowering their depression by 60% or more.
We track their progress on the back end through machine learning. We have a predictive model that shows how they're performing. And then we have interventions in the app and through the providers — we can send messages to our providers about how people are doing and when they need to intervene. So it's a lot of underlying technology to really enable people to drive the behavior change.
Vida goes to market primarily by signing up large enterprises to provide its service as a healthcare benefit to employees, or to policy holders of health insurance companies. Customers and partners include employers such as Boeing, Cisco and Visa, or insurers such as Centene, Humana and Florida Blue. It has also teamed up with drugstore chain CVS, which will offer Vida to employers as part of its pharmacy benefit management offering.
Areas of shared interest with Workday
With employee wellbeing high on enterprise agendas in the wake of the pandemic, it's no surprise to find Workday investing in a company like Vida. But there are other areas of shared interest too, such as a focus on data and analytics. The health data that can now be collected and analyzed opens up a completely new approach to healthcare that Vida and others are pioneering. Tilenius elaborates:
We haven't really captured this kind of data in the past. We haven't captured mood, or sleep, or stress, or nutrition. You're going to be able to get continuous glucose monitoring — right now, you have to have a needle to get that, but for the most part that's going to be from the wrist. You're going to see a lot more innovation in getting daily data and people managing their health on a daily basis.
A related aspect that made Vida an attractive investment was its platform approach, says Leighanne Levensaler, EVP of Workday Corporate Strategy and co-head of Workday Ventures. Tilenius previously worked at eBay and Google where she built products in commerce and payments that scale to millions of users — and so brought that approach to Vida. Indeed, it was while working on those projects in California while her father was coping with multiple healthcare conditions in Ohio that she first became aware of the need for an app of this kind. She recalls:
I couldn't figure out why there wasn't a mobile solution for managing his health where he could actually get day-to-day accountability from a coach or a therapist. I couldn't figure out why I couldn't see devices with all his data and connect, to make sure he was doing okay — and connect with his doctors to know what meds he was taking ...
Everything that I used in my life, whether that be Amazon, or eBay, or Google, was all so digitally enabled, that I was struck by how we were really missing this in healthcare.
Vida as a platform with network effects
The point about her background in those companies is that it taught Tilenius to think about creating a product that people would use multiple times a day. That led to what Vida calls its 'polychronic' approach. Tilenius explains:
From day one we said we're going to take a platform approach, we're not going to build a separate app for hypertension, or a separate app for mental health, or a separate app for diabetes. We're going to meet the person where they're at, we're going to use technology, and understand all their data and who they are. And then [use] machine learning to actually customize and personalize the experience to really help them achieve their outcomes.
Then on the back end, think about it, what's really exciting is there's network effects. The more people you get on the platform, the more data. Then you're able to do predictive analytics ... you can look at predictive analytics for a population and a whole country.
The size of that user population has expanded dramatically during the past year as the experience of COVID-19 has accelerated take-up of virtual healthcare and wellbeing solutions. Tilenius sees this as a welcome expansion of access to timely healthcare, pointing out that the Vida app doesn't replace healthcare professionals with automated alternatives. Instead, it helps them focus their attention where it's most effective. She explains:
The way we see the next decade is really simple. Essentially, you're allowing human providers to practice at the top of their license by using technology and digital therapeutics. So doctors will practice at the top of their license. And then nurses, coaches, therapists will practice at the top of their license. Digital therapeutics and bots will do the rest and enable access to a lot more care for a lot more people in the world. And all the money that we spend today — 90% of our healthcare, $4 trillion, is spent on reactive care — that'll shift. We'll shift to this continuous-care, proactive mode, with daily data that's coming from that.
One of the most frequently cited changes in behavior brought on by the pandemic has been the sudden rise of telemedicine. Despite the shortage of medical professionals that Tilenius alludes to, we had persisted in making access to healthcare as tortuous and inconvenient as possible until the pandemic suddenly forced us to access it remotely. And now no one wants to go back to sitting in physician waiting rooms to attend 10-minute consultations that can be done just as easily via messaging or a video meeting link.
The absurdity is that there is so much more that can be achieved by digitizing the healthcare experience and analyzing the wealth of data that can now be collected using mobile or wearable devices. But starting from where we were — the starting point that Philips had chosen — made the journey too difficult. Vida has come from the other direction, carefully selecting a range of common conditions that are highly amenable to behavioral guidance and then delivering its solution at scale.
That to my mind is what makes this such an exciting investment, quite apart from the other companies in the Workday Ventures portfolio in the breadth of its potential market. Vida is building a platform to deliver healthcare in an entirely new, digital-native way that delivers better outcomes to people who are poorly served by incumbent offerings. This is a classic disruptive innovation, and one to watch.
[Updated March 15th - due to a transcription error, the original version of this article quoted a reduction in depression after six months of 16%, now corrected to 60%]